Ethnic differences in coronary anatomy, left ventricular mass and CT-derived fractional flow reserve.
J Cardiovasc Comput Tomogr
; 15(3): 249-257, 2021.
Article
em En
| MEDLINE
| ID: mdl-33041249
ABSTRACT
BACKGROUND:
Studies have observed higher incidence of cardiovascular mortality in South Asians (SA), and lower prevalence in East Asians (EA), compared with Caucasians. These observations are not entirely explained by ethnic differences in cardiovascular risk factors and mechanistic factors such as variations in cardiac anatomy and physiology may play a role. This study compared ethnic differences in CT-assessed left ventricular (LV) mass, coronary anatomy and non-invasive fractional flow reserve (FFRCT).METHODS:
Three-hundred symptomatic patients (age 59 ± 7.9, male 51%) underwent clinically-mandated CT-coronary-angiography (CTA) were matched for age, gender, BMI and diabetes (100 each ethnicity). Assessment of coronary stenosis, luminal dimensions and vessel dominance was performed by independent observers. LV mass, coronary luminal volume and FFRCT were quantified by blinded core-laboratory. A sub-analysis was performed on patients (n = 187) with normal/minimal disease (0-25% stenosis).RESULTS:
Stenosis severity was comparable across ethnic groups. EA demonstrated less left-dominant circulation (2%) compared with SA (8.2%) and Caucasians (10.1%). SA compared with EA and Caucasians demonstrated smallest indexed LV mass, coronary luminal volumes and dimensions. EA compared with Caucasians had comparable indexed LV mass, coronary luminal dimensions and highest luminal volumes. The latter was driven by higher prevalence of right-dominance including larger and longer right posterior left ventricular artery. FFRCT in the left anterior descending artery (LAD) was lowest in SA (0.87) compared with EA (0.89; P = 0.009) and Caucasians (0.89; P < 0.001), with no difference in other vessels. All observed differences were consistent in patients with minimal disease.CONCLUSION:
This single-centre study identified significant ethnic differences in CT-assessed LV mass, coronary anatomy and LAD FFRCT. These hypotheses generating results may provide a mechanistic explanation for ethnic differences in cardiovascular outcomes and require validation in larger cohorts.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Angiografia Coronária
/
Vasos Coronários
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Estenose Coronária
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Reserva Fracionada de Fluxo Miocárdico
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Tomografia Computadorizada Multidetectores
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Angiografia por Tomografia Computadorizada
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Ventrículos do Coração
Tipo de estudo:
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Equity_inequality
/
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Austrália